Will “Product” rather than “Project” Orientation Help Healthcare Organizations Innovate Faster?

Meaningful change in the way we deliver clinical care in American healthcare organizations is a slow and arduous path. Much has been written about the gravity that healthcare holds, from complex business and clinical operations to regulations to bespoke arrangements with payors.

We are always looking for ways to measure and improve to deliver value to our patients and staff members faster. But we are not a start-up company — we are embedded within a complex non-profit healthcare organization. If we measure innovation as delivered value to patients (utilization of services, clinical care outcomes), how can we accelerate?

We recently did a major pivot, the first big reorganization of Inception Health since, well, its inception. We have recently adjusted our internal team’s structure to bring more focus and look at experiences holistically and over their entire lifecycle, rather than a chain of independent projects.

In our digital innovation team, we have begun to think about products that we provide. The differentiation from projects is important. Both have objectives and may have milestones (new features or expansions). But projects have start dates and end dates. Many of our digital services do not have end dates. And the risk of running them as a ‘project’ is that the maintenance is often underestimated, underfunded, and under-supported.

Situational Awareness and Flexibility

We have written in the past about Agile methodologies in health care. We (continue to) believe that healthcare is a complex adaptive system and that it is nearly impossible to account for all outcomes even with meticulous planning. An ability to adapt to changing requirements and business needs and to deliver working experiences that can grow over time is critical.

We have adjusted our processes to account for these changing requirements. And we have been building additional engineering capabilities that enable us to have more thoughtful conversations around “build vs. buy” for digital capabilities.

Through organization in products, we can designate clear product managers and product owners to be responsible for these areas and their intersections between health care operations and digital engineering.

We have also leveraged Team Topologies and the concept of the ‘stream-alined team’ for organizing our work.

Currently, we have designated ‘products’ for

• Visit-Based Care (reducing friction from scheduling to check-out)
• Longitudinal Care (a growth area of digital micro-interactions for healthy living, care management, and prevention)
• Digital Therapeutics
• Engineering — Mobile Development

Of course, we often will see areas crossing boundaries. And we will follow this over time to see how the interactions line up. We followed a discovery and clustering approach to our work to find natural areas of cohesive and coordinated work, though we are open to refining it as we gain experience.

Connecting to Process

We have been able to adjust our processes to be in line with our structure. By using a product approach, we can have teams be more accountable and engaged in making decisions that impact their areas, taking a longer lens to see how different aspects will be developed, maintained, and enhanced.

We may use a number of techniques or tools, and some may be cross-team or cross-functional depending on the phase. E.g. in discovery, we may use a design sprint or a well written RFC (request for comment) to lock down initial requirements and take through the design and build process.

Will it be Faster?

We believe so, but we will need to wait and see. Already we have seen that some alignment has enabled teams to view more of their arc of work. We have also discussed this approach with others in healthcare including BSW and UCSF, and we are seeing similar growth of the concept. We will continue to report out on our KPIs and methods as we track along.